Analysis

Ten-year study shows legalized abortion does not improve maternal mortality

abortion rate, pregnancy

Restrictions on abortion do not lead to an increase in women dying due to a lack of “safe” abortions, according to a new study highlighted by the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG).

In a recent tweet, AAPLOG cited a study published in the peer-reviewed medical journal BMJ Open, which examined maternal mortality in 32 Mexican states over a 10-year period, between 2002 and 2011. The study began by acknowledging the pro-abortion argument that “the legal status of abortion … is a factor that influences maternal health.” They also acknowledged the common argument that restrictions on abortion are thought to lead to “clandestine, or illegal, or unsafe abortions” leading to an increase in maternal deaths. 

But instead of discovering data in support of that argument, the study instead found that “states with less permissive abortion legislation exhibited lower MMR [maternal mortality rates]” (emphasis added) than those where abortion laws are more permissive. In other words, pro-life restrictions on abortion did not result in higher maternal mortality rates.

Even in Mexican states that enacted constitutional amendments outlawing abortion, women’s health did not suffer: “No evidence of deleterious or beneficial effect [on maternal mortality] was found for the presence of constitutional amendments protecting the unborn over a 4-year study period.”

To be clear, the Mexico study’s authors did not find evidence that abortion restrictions were the cause of better maternal outcomes. Independent variables between the states explained most of the differences in outcomes. As AAPLOG’s tweet pointed out, “non-legislative factors (female literacy, birth weight, skilled attendance at birth, clean water, etc.) were leading causes” in the lower maternal mortality rates in the states with more abortion restrictions. 

An attempted rebuttal published in the noted pro-abortion journal Contraception sought to undermine the Mexico study’s conclusions by attacking the authors’ use of the underlying data, while also engaging in ad hominem attacks. The paper claimed the Mexico study’s authors “have failed to respond to anti-abortion ‘junk science,’ which influences policy in the region,” claims an excerpt in Retraction Watch

Yet the critique did not hold up to scrutiny. “Sincerely, I don’t know how our study is ‘influencing’ policies in the region, and of course I don’t consider our work as ‘junk science’,” said Elard Koch, the main author of the Mexico study. After an examination of the data and counter-argument in the paper, Koch pointed out a major statistical error in key calculations of the rebuttal that undermined the published conclusions. The flaws in the Contraception article were serious enough that the editors were forced to issue a public retraction

READ: Flawed study falsely claims laws restricting late-term abortions increase maternal mortality

The finding that abortion restrictions do not cause higher mortality rates deals a blow to a common line of argument for abortion activists. The notion that maternal health suffers when abortion restrictions are enacted is a narrative that abortion activists often trot out in response to the enactment of new pro-life laws. In 2019, in response to Georgia’s heartbeat bill, Hillary Clinton tweeted, “When anti-choice politicians limit access to reproductive care, women die.” She argued that “we must continue to fight the new wave of six-week abortion bans that make women collateral damage for extremist views.”

The misperception about abortion and maternal mortality has its origins in a big lie told by early abortion activists. In the years leading up to the legalization of abortion, abortion activists like Dr. Bernard Nathanson (one of the founders of NARAL) disseminated false statistics about the number of women dying each year from illegal abortions, as Live Action News has reported. The widely cited figure — that 5,000 to 10,000 women were dying each year from back-alley abortions — was a deliberate fabrication designed to advance the pro-abortion agenda. Dr. Nathanson, who later became pro-life, admitted to fabricating this number because it was a “nice, round, shocking figure.” 

The Mexico study correlates with historical analyses of maternal mortality in the 20th century. As a Live Action Pro-Life Replies video notes, maternal mortality in the United States dropped precipitously in the decades prior to the legalization of abortion, and not as a result of legalized abortion. It was the advent of antibiotics like sulfa and penicillin in the mid-20th century, not abortion legalization, that resulted in the dramatic reduction of maternal mortality rates.

Current maternal mortality rate comparisons between countries further refute abortion activists’ arguments. Countries like Poland and Malta — which have tight abortion restrictions — have lower mortality rates, at three and nine deaths per 100,000 live births respectively, while the U.S. rate stands at 17 deaths per 100,000 according to the latest data, as Vox reported

If the Mexico study is right, then the remedy for maternal mortality is not permissive abortion legislation, and abortion activists need to stop using a deceptive narrative to further their cause. By doing so, they prevent us from getting at the real solutions to maternal mortality, as identified by the Mexico study: the “non-legislative factors,” or medical, social, and educational variables, that were shown to have a causal effect on maternal mortality rates.

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